Fri Jul 19 2024

94 articles - From Friday Jul 12 2024 to Friday Jul 19 2024

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Guidelines

Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…

Clin Gastroenterol Hepatol

AGA Clinical Practice Update on the Role of Intestinal Ultrasound in Inflammatory Bowel Disease: Commentary.

Methods This CPU was commissioned and approved by the AGA Institute Clinical Practice Updates Committee (CPUC) and the AGA Governing Board to provide timely guidance on a topic of high clinical importance to the AGA membership and underwent internal peer review by the CPUC and external peer review through standard procedures of Clinical Gastroenterology and Hepatology. This expert commentary incorporates important and recently published studies in this field, and it reflects the experiences of the multidisciplinary group of authors composed of adult and pediatric gastroenterologists.

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Gastroenterology

AGA Clinical Practice Update on Diagnosis and Management of Cyclic Vomiting Syndrome: Commentary.

Methods This CPU was commissioned and approved by the AGA Institute Clinical Practice Updates Committee (CPUC) and the AGA Governing Board to provide timely guidance on a topic of high clinical importance to the AGA membership, and underwent internal peer review by the CPUC and external peer review through standard procedures of Gastroenterology. This expert commentary incorporates important as well as recently published studies in this field, and it reflects the experiences of the authors who are experts in treating patients with cyclic vomiting syndrome.

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Meta-analysis

meta-analyses and systematic reviews

Gut

Prevalence of irritable bowel syndrome and functional dyspepsia after acute gastroenteritis: systematic review and meta-analysis.

In a large systematic review and meta-analysis, 14.5% of individuals experiencing acute gastroenteritis developed PI-IBS and 12.7% PI-FD, with greater than fourfold increased odds for IBS and threefold for FD. Proinflammatory microbes, including Proteobacteria and subcategories, and SARS-CoV-2, may be associated with the development of PI-IBS and PI-FD.

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J Hepatol

Impact of pre-transplant immune checkpoint inhibitor use on post-transplant outcomes in HCC: A systematic review and individual patient data meta-analysis.

Additionally, a higher number of immune checkpoint inhibitor cycles and tumor burden within Milan criteria at the completion of immunotherapy may predict a decreased risk of hepatocellular carcinoma recurrence, but this observation requires further validation in larger prospective studies. CODE FOR INTERNATIONAL PROSPECTIVE REGISTER OF SYSTEMATIC REVIEWS (PROSPERO): CRD42023494951.

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Original articles

RCT, clinical trials, retrospective studies, etc…

Aliment Pharmacol Ther

Clinical trial: The effectiveness of long-acting somatostatin analogue for output reduction of high-output intestinal fistula or small bowel enterostomy. A randomised controlled trial.

In patients with a high-output fistula or small bowel enterostomy, addition of lanreotide to current standard treatment can provide a clinically relevant output reduction.

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Faecal biomarkers for diagnosis and prediction of disease course in treatment-naïve patients with IBD.

This study provides new insight into the diagnostic and prognostic capability of neutrophil and eosinophil biomarkers in IBD and suggests that MPO, alone or in combination with FC, may add to the diagnostic power of faecal biomarkers.

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Outcomes of patients with alcohol-associated hepatitis and acute kidney injury - Results from the HRS Harmony Consortium.

Hospitalised patients with cirrhosis and AKI presenting with AH had higher 90-day mortality than those without AH, but this may have been driven by higher MELD-Na rather than AH itself. However, in patients with hepatorenal syndrome, AH was an independent predictor of mortality.

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The effect of vitamin E and docosahexaenoic acid ethyl ester on Metabolic Dysfunction-Associated steatotic Liver Disease (MASLD)-A randomised, double-blind, placebo-controlled, parallel-group clinical trial (PUVENAFLD).

The combination of DHA + vitamin E or either agent alone did not demonstrate efficacy on reducing liver fat or aminotransferases in the studied population.

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Am J Gastroenterol

Association of Acetaminophen (Paracetamol) Use with Severity and Outcomes in Patients with Viral Hepatitis-Associated Acute Liver Failure.

APAP use in AVH-ALF is common and may negatively impact outcomes compared to little or no APAP exposure. Prospective studies of the most safe and effective dose of APAP to use in patients with AVH are needed.

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Comparative risk of serious infection with vedolizumab vs anti-TNF in inflammatory bowel disease: results from nationwide Swedish registers.

Vedolizumab was associated with increased risks of serious infections compared to anti-TNF in Crohn's disease, but not in ulcerative colitis. Nonetheless, the panorama of serious infections seemed to differ between the drugs. Our findings underscore the importance of clinical awareness of infections and the safety profile of the two therapies.

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GLP1-RA use prior to endoscopy is associated with low retained gastric contents: a multicenter cross-sectional analysis.

In this multicenter study, very low rates of retained gastric contents were seen during endoscopy in patients on GLP1-RAs and most were in patients with T2DM. Our findings suggest an individualized approach rather than universal pre-operative holding of medications prior to endoscopy.

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HIV infection is associated with a less aggressive phenotype of inflammatory bowel disease. A multicenter study of the ENEIDA registry.

HIV infection appears to be associated with a less aggressive phenotype of IBD and a lesser use of non-biological therapies and biologicals but entails a greater risk of developing OI.

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Healthcare Resource Utilization and Costs Associated With Eosinophilic Esophagitis Among Commercially Insured Patients in the United States.

EoE imposes substantial economic burden. More effective and targeted treatments that improve outcomes for patients are needed.

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Histologic Activity from Neoterminal Ileal Biopsies in Patients with Crohn's Disease in Endoscopic Remission is Associated with Postoperative Recurrence.

In patients with postoperative CD, histologic activity despite complete endoscopic remission is associated with composite, endoscopic and radiographic, recurrence. Further understanding of the role of histologic activity in patients with Rutgeerts' i0 disease may provide a novel target to reduce disease recurrence in this population.

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Impact of Bowel Preparation Quality on Colonoscopy Findings and Colorectal Cancer Deaths in a Nation-Wide Colorectal Cancer Screening Program.

Fair bowel preparation on the Aronchick Scale was not only associated with a lower adenoma detection probability but also with increased risk of PCCRC death. Efforts should be made to increase bowel cleansing above fair scores.

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Impact of Diabetes, Drug-Induced Liver Injury, and Sepsis on Outcomes in MAFLD-Related Acute-on-Chronic Liver Failure.

Almost half of MAFLD-ACLF patients die within 90 days. Diabetes and non-viral precipitants such as DILI and sepsis lead to adverse outcomes. The new MAFLD-MELD-Na and MAFLD-AARC scores provide reliable 90-day mortality predictions for MAFLD-ACLF patients.

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Older Age as a Worrisome Feature in Patients With Intraductal Papillary Mucinous Neoplasms: a Long-Term Surveillance Study.

Older patients with IPMNs were at a higher risk of developing pancreatic carcinoma during surveillance. Surgically fit elderly patients may be good candidates for periodic surveillance aimed at a reduction of pancreatic cancer-related deaths.

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Psychiatric disorders among 5800 patients with microscopic colitis: A nationwide population-based matched cohort study.

Patients with MC are at increased risk of incident psychiatric disorders compared to the general population.

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The Liver Cirrhosis Network Cohort Study: Cirrhosis Definition, Study Population, and Endpoints.

The LCN Cohort Study design will inform the natural history of cirrhosis in contemporary patients with compensated cirrhosis. The LCN Definitions and Measures Committee developed criteria for the definition of cirrhosis to standardize entry into this multi-center cohort study and standardized criteria for liver-related outcome measures. This effort has produced definitions intended to be both sensitive and specific as well as easily operationalized by study staff such that outcomes critical to the LCN cohort are identified and reported in an accurate and generalizable fashion.

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The Survival Benefit of Re-abstinence After Harmful Alcohol Use Following Early Liver Transplant for Severe Alcohol-Associated Hepatitis: A Multi-Center ACCELERATE Study.

Achieving re-abstinence after post-LT harmful alcohol use is associated with similar five-year post-LT survival compared to those without evidence of post-LT harmful alcohol use. Our findings highlight the importance of early detection and treatment of post-LT alcohol use.

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When Perfect Is the Enemy of Good: Results of a RAND Appropriateness Panel on Treat to Target in Asymptomatic IBD.

Appropriateness ratings can help guide clinical decision-making about changing therapy to achieve endoscopic remission in asymptomatic patients with IBD until data from ongoing randomized studies are available.

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Clin Gastroenterol Hepatol

Drug-Induced Liver Injury in Latin America: 10-year experience of the Latin American DILI (LATINDILI) Network Drug-induced liver injury in Latin America.

Features of DILI in Latin America are comparable to other prospective registries. However, the pattern of drugs responsible for DILI differs. An increasing incidence of HDS, with high mortality rate, and likewise nimesulide and nitrofurantoin was noted. Thus, public health policies should raise awareness of the potential adverse effects of these compounds.

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Dynamics of liver stiffness measurement and clinical course of primary biliary cholangitis.

Tracking longitudinal changes in LSM using VCTE provides valuable insights into PBC prognosis, offering a robust predictive measure for the risk of SCE. LSM could be used as a clinically relevant surrogate endpoint in PBC clinical trials.

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Endoscopy

Prospective feasibility study of a novel rigidizing stabilizing overtube in the resection of complex gastrointestinal polyps.

The novel ROT was safe, with high technical and clinical success during resection of complex colon polyps. Future studies will determine timing of implementation during routine endoscopic resection.

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Gastroenterology

Gut Pathobiont-Derived Outer Membrane Vesicles Drive Liver Inflammation and Fibrosis in PSC-IBD.

This study demonstrates the contribution of gut pathobionts in releasing OMVs that traverse the mucosal barrier, and thus, promote liver inflammation and fibrosis in PSC-IBD. OMVs might represent a critical new environmental factor that interacts with other disease factors to cause inflammation and thus define potential new targets for fibrosis therapy.

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Molecular Mechanisms Underlying Loss of Vascular and Epithelial Integrity in Irritable Bowel Syndrome.

Epithelial and vascular barriers are compromised in IBS patients and contribute to clinical manifestations.

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The global incident gastrointestinal cancers attributable to suboptimal diets from 1990 to 2018.

Although the proportional attributable GI incidence remains relatively stable, the doubling of absolute cases from 1990 to 2018, along with the discrepancies among urbanicity and countries/regions, informs dietary priorities and more targeted preventive measures.

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Hepatology

An integrated analysis of bile acid metabolism in humans with severe obesity.

Characterization of the portal BA composition in relation to peripheral and fecal BA increased insight into the dynamics of BA metabolism in individuals with obesity. Peripheral BA composition was much more diverse due to microbial metabolism. About 24% of the portal samples was surprisingly low in total BA; the underlying mechanism requires further exploration.

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J Hepatol

Effect of pemvidutide, a GLP-1/glucagon dual receptor agonist, on MASLD: A randomized, double-blind, placebo-controlled study.

In subjects with MASLD, weekly pemvidutide treatment yielded significant reductions in LFC, markers of hepatic inflammation, and body weight compared to placebo. Impact and implications MASLD, and MASH, are strongly associated with overweight and obesity and it is believed that the excess liver fat associated with obesity is an important driver of these diseases. Glucagon-like peptide-1 receptor (GLP-1R) agonists elicit weight loss through centrally and peripherally mediated effects on appetite. Unlike GLP-1R agonists, glucagon receptor (GCGR) agonists act directly on the liver to stimulate fatty acid oxidation and inhibit lipogenesis, potentially providing a more potent mechanism for liver fat content (LFC) reduction than weight loss alone. This study demonstrated the ability of once-weekly treatment with pemvidutide, a dual GLP-1R/GCGR agonist, to significantly reduce LFC, hepatic inflammatory activity, and body weight, suggesting that pemvidutide may be an effective treatment for both MASH and obesity. Clinical trial number NCT05006885.

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Infection history imprints prolonged changes to the epigenome, transcriptome and function of Kupffer cells.

Our study demonstrates that a prior exposure to a parasitic infection induces trained immunity in KCs, reshaping their identity and function in the long-term. Impact and implications Although the liver is frequently affected during infections, and despite housing a major population of resident macrophages known as Kupffer cells (KCs), it is currently unclear whether infections can durably alter KCs and their niche cells. Our study provides a comprehensive investigation into the long-term impact of a prior, cured parasitic infection, unveiling long-lasting ontogenic, epigenetic, transcriptomic and functional changes to KCs as well as KC niche cells, which may contribute to KC remodeling. Our data suggest that infection history may continuously reprogram KCs throughout life with potential implications for subsequent disease susceptibility in the liver, influencing preventive and therapeutic approaches.

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Patient-reported outcomes in chronic hepatitis delta: An exploratory analysis of the Phase III MYR301 trial of bulevirtide.

PROs indicate that 48-week treatment with bulevirtide monotherapy may improve aspects of HRQoL in patients with CHD. Impact and implications Bulevirtide 2 mg is the only approved treatment for patients with chronic hepatitis delta (CHD) in the EU. Patients with CHD have worse quality of life scores than those with chronic hepatitis B. Bulevirtide treatment for 48 weeks reduced HDV RNA and alanine aminotransferase levels and was well tolerated among patients with CHD. For the first time, this study shows that patients who received bulevirtide therapy for 48 weeks reported improvements in physical and hepatitis-related quality of life domains compared to those who did not receive therapy (control group). Clinical trial registration

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Varied immune responses of HBV-specific B cells in patients undergoing pegylated interferon-alpha treatment for chronic hepatitis B.

After PEG-IFNα treatment, HBsAg- and HBcAg-specific B-cells exhibit various changes in antibody secretion. Their functional differences are reflected in the alterations in phenotypes and subtypes. The presence of CD40L + Tfh-cells is associated with the active recovery of HBsAg-specific B-cells. Impact and implications HBV-related complications and hepatocellular carcinoma remain the leading causes of mortality from chronic liver disease worldwide, and a cure is rarely achieved with antiviral therapies. Elucidating the immunological mechanisms underlying the functional cure of CHB patients offers a promising therapeutic strategy for viral clearance, such as therapeutic vaccine. We analyzed the alterations in HBV-specific B-cells in patients treated with PEG-IFNα and identified novel pathways for immunotherapeutic boosting of B cell immunity.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Aliment Pharmacol Ther

Editorial: Trajectory of soluble programmed cell death protein-1 and ligand-1 in HBV-infected individuals treated with pegylated interferon-implications for stopping rules and the HBV cure programme.

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Clin Gastroenterol Hepatol

Diet and Microbiome-directed therapy 2.0 for IBD.

We also review the use of diet as a therapeutic tool in IBD, including the effects in induction and maintenance, special diets, and exclusive enteral nutrition. Finally, we highlight the challenges and opportunities for the translation of diet and microbiome interventions into clinical practice, such as the need for personalization, manufacturing and regulatory hurdles, and the specificity to take into account for clinical trial design.

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How Artificial Intelligence Will Transform Clinical Care, Research, and Trials for Inflammatory Bowel Disease.

As a complex disease with entangled relationships between genomics, metabolomics, microbiome, and the environment, IBD stands to benefit greatly from methodologies that can handle this complexity. We describe current applications, critical challenges, and propose future directions of AI in IBD.

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Prediction and Prevention of Inflammatory Bowel Disease.

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Setting a value for novel GERD treatments.

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Gastroenterology

Shot heard around the world? Subcutaneous Infliximab (CT-P13) as Maintenance Therapy for Inflammatory Bowel Disease.

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Gut

Untargeted faecal metabolomics for the discovery of biomarkers and treatment targets for inflammatory bowel diseases.

In this article, we describe the contribution of metabolomics research to the field of IBD, with a focus on faecal metabolomics. We discuss the latest findings on the significance of these metabolites for IBD prognosis and therapeutic interventions and offer insights into the future directions of metabolomics research.

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Miscellaneous

misc publications eg case reports, tools of the trade, images of the month, etc…

Am J Gastroenterol

A Comprehensive Comparative Study of Potassium-Competitive Acid Blockers Is Necessary.

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Calendar of Courses, Symposiums and Conferences.

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Comparing Short-Term Dual vs Standard Quadruple Therapy for Helicobacter pylori Eradication.

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Correction to: Supplementation With Oral vs Intravenous Iron for Anemia With IBD or Gastrointestinal Bleeding: Is Oral Iron Getting a Bad Rap?

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Diaphragmatic Hernia: A Rare But Potentially Severe Complication After Radiofrequency Ablation of the Liver.

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Ectopic Adrenocorticotropic Hormone Syndrome Caused by Villous Adenoma in Sigmoid Colon.

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Improving Insights Into Ultra-processed Food Consumption and Gastrointestinal Cancer Risk.

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Mortality in Acute Severe Ulcerative Colitis - Still an Alarming and Real Complication in the Era of Advanced Therapies.

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Response to Kathuria, Higgins, and Berinstein.

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Response to Lunagariya et al.

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To Continue or Discontinue β-Blockers in Secondary Prophylaxis? That is the Dilemma.

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What Is the Skinny on This Unusual Esophageal Finding: A Rare Case of Esophageal Epidermoid Metaplasia.

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Clin Gastroenterol Hepatol

A Practical Approach to Navigating Relevance, Regulatory, and Reimbursement in Gastroenterology Innovation for Gastroenterology Trainees.

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Practice Innovations to Optimize GI Access by Enhancing Existing Supply and Right-Sizing Demand.

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Endoscopy

A novel gastric defect closure method using lines and reopenable clips with the through-the-scope tying technique.

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A transanal alpha-loop tube facilitates endoscopic submucosal dissection of a distal rectal tumor.

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Alternative endoscopic ultrasound-guided choledochogastrostomy for anatomical inaccessibility by usual biliary drainage methods.

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Clip-anchored floss traction-assisted endoscopic submucosal dissection combined with endoscopic tunneling in treatment of long circumferential early esophageal carcinoma.

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Does radiofrequency ablation affect endoscopic submucosal dissection in Barrett's esophagus?

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Double nylon loop-based inner traction technique promoting endoscopic submucosal dissection of a giant pedunculated adenoma in the ascending colon.

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Doughnut-shaped endoscopic submucosal dissection for circumferential ileocecal valve adenoma.

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Dual-sided closure of an iatrogenic gastrocolonic fistula with over-the-scope clips.

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Endoscopic submucosal dissection for resection of giant adenoid cystic carcinoma of the esophagus.

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Endoscopic suturing system is the last chance for rectal bleeding after complicated endoscopic submucosal dissection.

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Prophylactic saline-immersion snare-tip vessel coagulation after colorectal endoscopic resection.

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Salvage circumferential endoscopic submucosal dissection of multifocal Barrett's adenocarcinoma at an esophagogastric anastomosis.

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Gastroenterology

A Rare Case of Skin and Small Intestine Pigmentation.

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Fibroblast activation protein (FAP) is overexpressed on both stromal and epithelial cells prior to pancreatic ductal adenocarcinoma: implications for early diagnosis on 68Ga-FAPI-PET/CT.

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Inflammatory markers at birth and risk of early onset inflammatory bowel disease.

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Pouchitis: Is It Time to Think Beyond the Inflammation in the Pouch?

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Prevotella Is Associated with Sex-Based Differences in Irritable Bowel Syndrome.

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The Mysterious Cause of Refractory Diarrhea and Weight Loss in a Young Woman.

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Treating Multiple Food Allergies with Omalizumab.

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Hepatology

Accurate predictor for liver disease progression in patients with DC/TBD.

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Alcohol-associated liver disease: The time to act is now.

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August Hepatology Highlights.

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Developing Quality Measures for Improving Pre-Liver Transplant Care.

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Diagnosis and Management of Hepatocellular Carcinoma.

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Hepatology Highlights.

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Letter to the Editor: Exercise greater caution in bile acid research.

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Letter to the Editor: The causal analysis of missing confounding-factors for the association between HDV with specific liver events.

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Reply: Clinical outcomes and prognostic factors after HCV clearance with DAA in HIV/HCV-coinfected patients with advanced fibrosis/cirrhosis.

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Reply: The causal analysis of missing confounding-factors for the association between HDV with specific liver events.

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S-pecial Delivery: Implications of HBV Surface Antigen Subviral particles Carrying microRNA Payloads.

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Letters&Replies

Letters to the editors and authors’ replies

Aliment Pharmacol Ther

Editorial: Trajectory of soluble programmed cell death protein-1 and ligand-1 in HBV-infected individuals treated with pegylated interferon-Implications for stopping rules and the HBV cure programme. Authors' reply.

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Letter: Drug interaction in resmetirom times.

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Letter: MAFLD versus MASLD-The devil lies in the details.

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Letter: Microbial manipulation for primary sclerosing cholangitis-associated inflammatory bowel disease-hope on the horizon.

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Letter: Post-endoscopic management after upper gastrointestinal bleeding-Replenishment of iron loss.

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Letter: Reflections on the role of over-the-scope clips in high-risk upper gastrointestinal bleeding-Authors' reply.

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Letter: Reflections on the role of over-the-scope clips in high-risk upper gastrointestinal bleeding.

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Letter: Risks of proton pump inhibitor treatment in cirrhotic patients-Authors' reply.

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Clin Gastroenterol Hepatol

Evaluating Real World Consistency and Accuracy by ChatGPT4 for Post-Colonoscopy Follow-Up Recommendations.

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Gut

Reassessing gastroscopy practices: the need for improved methodology and interpretation.

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J Hepatol

Considering socioeconomic status and lifestyle interventions to enhance personalized medical care for CHB in Asian patients residing in Western countries.

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